Delivery Assist Catheters : A new Device Class and Initial Experience in Mechanical Thrombectomy in Acute Ischemic Stroke Patients

Clin Neuroradiol. 2019 Dec;29(4):661-667. doi: 10.1007/s00062-018-0725-x. Epub 2018 Sep 6.


Purpose: To report in vivo experience of a delivery assist catheter as ascending aid for a large-bore catheter for intracranial thromboaspiration.

Methods: Retrospective data collection and analysis of stroke databases of two comprehensive stroke centers focusing on technical and angiographic parameters - primary endpoint defined as reaching the occlusion with a large-bore reperfusion catheter - from patients receiving endovascular stroke treatment using an AXS Offset™ delivery assist catheter (Stryker, Fremont, CA, USA) between May 2017 and November 2017.

Results: Using the delivery assist catheter, a 6F catheter could be advanced to an intracranial occlusion for direct thromboaspiration in 30 (88.2%) out of a total of 34 patients (male: n = 14 out of 34 [41.2%], age in years: mean [SD]: 75 [11], median baseline NIHSS [National Institutes of Health stroke scale]: 16 [interquartile range, IQR 12-21]). In 4 out of 34 (11.7%) cases the occlusion could not be reached with the aspiration catheter because of a preceding non-occlusive arteriosclerotic plaque (n = 1, 2.9%) or because of severe elongation and tortuosity of the arterial access route (n = 3, 8.8%). After thromboaspiration mTICI (modified thrombolysis in cerebral infarction) 2b‑3 was reached in 14 out of 30 (46.7%) patients. In 21 out of 34 (61.8%) patients stent-retriever-maneuvers (median: 1 [IQR: 0‑2]) were needed. In 28 out of 34 (82.3%) patients final mTICI 2b-3 could be achieved.

Conclusion: Delivery assist catheters can be used as ascending aid for large-bore catheters for thromboaspiration in acute ischemic stroke, in particular to overcome vessel tortuosity and anatomic obstacles.

Keywords: Acute ischemic stroke; Anatomic obstacle; Large bore catheter; Thromboaspiration; Vessel tortuosity.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiography
  • Brain Ischemia / complications
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / surgery*
  • Carotid Arteries / diagnostic imaging
  • Catheters
  • Databases, Factual
  • Female
  • Fluoroscopy
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Stents
  • Stroke / diagnostic imaging
  • Stroke / etiology
  • Stroke / surgery*
  • Thrombectomy / adverse effects
  • Thrombectomy / instrumentation*
  • Thrombectomy / methods